FODMAPs are fermentable carbohydrates that are absorbed in our intestines. They are found in many common foods like wheat, milk, garlic, peaches, and other more processed products made from those ingredients. You can read more about FODMAPs as a whole here, but today we’re going to focus on just one part.
The “P” in FODMAP
The “P” in FODMAP stands for polyols, which are sugar alcohols. Polyols occur naturally in certain fruits and vegetables but are also artificially made to substitute sugar.
So, how do they work? Polyols attract water as they move through the bowel and then are malabsorbed once they reach the colon. This is where bacterial fermentation takes place which may then lead to digestive symptoms like gas, bloating, diarrhea, and/or cramping.
Like other FODMAPs, polyols are dose-dependent. This means that it really depends on how much of a polyol-containing food you consume that will determine if you have symptoms or not.
What are the names of different polyols?
There are eight different polyols: erythritol, hydrogenated starch hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol. The polyols that you will see highlighted in the Monash FODMAP app are sorbitol and mannitol, as they are the most prevalent in fruits and vegetables. Isomalt, lactitol, xylitol, and maltitol are commonly used as sugar substitutes in many diet or “sugar-free” foods. Those three have also been found to cause GI distress. Erythritol is one polyol that is typically better tolerated, as it is absorbed a little more efficiently in the intestines. This means it’s unlikely to cause GI distress and would be suitable on a Low FODMAP diet.
Where exactly can we find them?
Polyols are found in many different foods, but here are a few common ones you may come across:
- Sorbitol: Apples, avocados, green bell peppers, blackberries, stone fruits like peaches, plums, and cherries contain sorbitol.
- Mannitol: Mushrooms, celery, cauliflower, and sweet potato contain Mannitol.
- Isomalt: This polyol contains both sorbitol and mannitol. It is commonly found in sugar-free products like gum, mints, and ice cream.
- Lactitol, Maltitol, and Xylitol: These are also found in sugar-free products like gum, mints, and ice cream.
- Erythritol: This polyol has not been found to be a big issue unless consumed in very large amounts. Like some of the other polyols, it’s found in sugar-free products like gum, mints, and ice cream.
Pros & Cons
A common misconception among those with IBS is that all FODMAPs are bad. This is not the case! FODMAPs offer various benefits, but they can cause some unwanted digestive symptoms if you have IBS. Let’s take a look at some of the pros and cons of polyols:
- Dentist approved: Polyols used in gum and mints do not promote tooth decay.
- Diabetes-friendly: They do not make blood sugar levels rise, making them ideal for someone with Diabetes Mellitus (DM).
- Low-Calorie: They have fewer calories per gram compared to sucrose.
- Constipation-helper: If you don’t have a poor tolerance to polyols and suffer from constipation, they may increase gut transit motility. One good option: prunes!
- Microbiome diversity: A few small studies have found that certain polyols may have a prebiotic effect on our microbiome. These studies showed an increase in bifidobacteria.
- IBS trigger: You may find an increase in GI symptoms in those with IBS, as polyols can have a laxative effect. In healthy individuals, they’re typically dose-dependent (10-20g at one time). Common symptoms are gas, bloating, and diarrhea.
- Restriction: If you find that they do trigger your IBS symptoms, you may feel overly restricted with food. Be sure to utilize the Low FODMAP serving size of polyols and work on increasing your tolerance over time.
What should I look out for if I’m avoiding polyols? What substitutes can I eat?
If you’re in the elimination phase of the Low FODMAP diet, you may be avoiding polyols. This requires not only label reading, but options for swaps! Here are a few things to consider:
- Label reading: Be sure to look out for anything that ends in an “ol” on an ingredient list — these items indicate sugar alcohols. They are commonly found on packages that are labeled “diet”, “sugar-free” or “keto”. If you do see an item with a sugar alcohol, look for an alternative product made with Stevia or an artificial sweetener. You can also look for products made with plain old table sugar (aka sucrose).
- Fruit and vegetable swaps: For every food high in polyols, there is a Low FODMAP-friendly swap! Here are a few of our favorites:
- Instead of apples, try oranges.
- Instead of blackberries, try strawberries.
- Instead of button mushrooms, try oyster mushrooms.
- Instead of cauliflower, try broccoli.
- Instead of green bell peppers, try red bell peppers.
Finally, remember that polyols are portion size-dependent. If you do find that they are one of your IBS triggers, there is likely a smaller serving size that will be well tolerated!